<%-- 
    Document   : mem_details
    Created on : Oct 7, 2009, 3:36:00 AM
    Author     : bharath
--%>
<jsp:useBean id ="ms" scope="session" class="Login.MySqlConnector"/>
<jsp:setProperty name="ms" property="*" />
<%@ page import="java.io.* ,java.util.*, java.sql.*, Login.*"%>
<%@ page contentType="text/html; charset=iso-8859-1" language="java" import="java.sql.*" errorPage="" %>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
        <title>SCF - Registration</title>
        <link rel="stylesheet" href="./css/yellow.css" />
        <link rel="stylesheet" href="./css/small.css" />
		<link href="style.css" rel="stylesheet" type="text/css" />
        <!-- Loading Calendar JavaScript files -->
        <script type="text/javascript" src="./js/zapatec.js"></script>
        <script type="text/javascript" src="./js/calendar.js"></script>
        <!-- Loading language definition file -->
        <script type="text/javascript" src="./js/calendar-en.js"></script>
        <meta http-equiv="content-type" content="text/xml; charset=utf-8" />
       
        <script type="text/javascript">
		
		function getXMLObject()  //XML OBJECT
            {
                var xmlHttp = false;
                try {
                    xmlHttp = new ActiveXObject("Msxml2.XMLHTTP")  // For Old Microsoft Browsers
                }
                catch (e) {
                    try {
                        xmlHttp = new ActiveXObject("Microsoft.XMLHTTP")  // For Microsoft IE 6.0+
                    }
                    catch (e2) {
                        xmlHttp = false   // No Browser accepts the XMLHTTP Object then false
                    }
                }
                if (!xmlHttp && typeof XMLHttpRequest != 'undefined') {
                    xmlHttp = new XMLHttpRequest();        //For Mozilla, Opera Browsers
                }
                return xmlHttp;  // Mandatory Statement returning the ajax object created
            }

            var xmlhttp = new getXMLObject();	//xmlhttp holds the ajax object
				
		function validate(register)
		{
		if ( register.name.value == "" )
		{
			alert("Enter Valid Name");
			register.name.focus() ;
			return false;
		}
		if ( register.name.value.length >= 45 )
		{
			alert("Name should be less than 45 characters");
			register.name.focus() ;
			return false;
		}
		
    	if (register.surname.value == "")
		{
				alert("Enter valid surname");
				register.surname.focus();
				return false ;
		}
		if (register.surname.value.length >= 45)
		{
				alert("Surname should be less than 45 characters");
				register.surname.focus();
				return false ;
		}
		if (register.age.value == "")
		{
			alert("Enter Valid Age");
			register.age.focus() ;
			return false;
		}

	if (register.dob.value == "")
		{
			alert("Enter Valid Date of Birth");
			register.dob.focus() ;
			return false;
		}
    	if (register.resadd.value == "")
		{
				alert("Enter valid Residance");
				register.resadd.focus();
				return false ;
		}
        if (register.mobile.value == "")
		{
				alert("Enter valid mobile");
				register.mobile.focus();
				return false ;
		}
		// only allow numbers to be entered
var checkOK = "0123456789";
var checkStr = register.mobile.value;
var allValid = true;
var allNum = "";
for (i = 0;  i < checkStr.length;  i++)
{
ch = checkStr.charAt(i);
for (j = 0;  j < checkOK.length;  j++)
if (ch == checkOK.charAt(j))
break;
if (j == checkOK.length)
{
allValid = false;
break;
}
if (ch != ",")
allNum += ch;
}
if (!allValid)
{
alert("Please enter only digit characters in the numbers field.");
register.mobile.focus();
return (false);
}
		
        
		if (register.prof.value=="--")
		{
				alert("Enter valid Proffession");
				register.prof.focus();
				return false ;
		}
       if(register.checkbox.checked == false )
			{ 
			
			alert("Click the declaration Check box");
			return false ;
			}
		}
		
			function SpouseSex()
			{
				var sex = document.getElementById("sex");
			 	var opt = sex.options[sex.selectedIndex];
			}

            function sendage()
            {
             	var dob1 = document.getElementById("dob").value;                
                //alert("date of birth is "+dob1);            
				var year=dob1.split("-");				
				var today=new Date();
				var byear=year[2];
				var cyear=today.getYear();
				var age1 = (parseInt(cyear)-parseInt(byear));
				document.getElementById("age").value = age1 ;
				document.getElementById("declage").value = age1;
			}
			function Getdecl()
			{
			var dname = document.getElementById("name").value;
			document.getElementById("decl").value = dname;
			}
      		function getDistricts() {
                var sel = document.getElementById("state");
                var opt = sel.options[sel.selectedIndex];
                var d = opt.value || opt.text;

                if(xmlhttp) {
                    xmlhttp.open("GET","AJAXGetDistricts?state=" +d,true);
                    xmlhttp.onreadystatechange  = handleServerResponse;
                    xmlhttp.setRequestHeader('Content-Type', 'application/x-www-form-urlencoded');
                    xmlhttp.send(null);
                }
            }


            function getMandals() {
                var districts = document.getElementById("district");
                var opt1 = districts.options[districts.selectedIndex];
                var d1= opt1.value || opt1.text;
                //alert(d1);
                if(xmlhttp) {
                    xmlhttp.open("GET","AJAXGetMandals?district=" +d1,true);
                    xmlhttp.onreadystatechange  = handleServerResponse1;
                    xmlhttp.setRequestHeader('Content-Type', 'application/x-www-form-urlencoded');
                    xmlhttp.send(null);
                }
            }
            function handleServerResponse() {
                if (xmlhttp.readyState == 4) {
                    if(xmlhttp.status == 200) {
                        document.getElementById('district').options.length = 0;
                        var elemnt = document.getElementById("district");
                        var textToSplit = xmlhttp.responseText;
                        var returnElements=textToSplit.split("|");
                        var valueLabelPair=null;

                        document.getElementById('district').options[0] = new Option("Select","select");
                        for ( var i=0; i<(returnElements.length-1); i++ ){
                            valueLabelPair = returnElements[i].split("|");
                            document.getElementById('district').options[i+1] = new Option(valueLabelPair[0], valueLabelPair[1]);
                        }
                    }else {
                        alert("AJAX Call Error Please try again");
                    }
                }
            }
            function handleServerResponse1() {
                if (xmlhttp.readyState == 4) {
                    if(xmlhttp.status == 200) {
                        document.getElementById('mandal').options.length = 0;
                        var elemnt = document.getElementById("mandal");
                        var textToSplit = xmlhttp.responseText;
                        var returnElements=textToSplit.split("|");
                        var valueLabelPair=null;
                        for ( var i=0; i<(returnElements.length-1); i++ ){
                            document.getElementById('mandal').options[i] = new Option("","");
                        }
                        document.getElementById('mandal').options[0] = new Option("Select","select");
                        for ( var i=0; i<(returnElements.length-1); i++ ){
                            valueLabelPair = returnElements[i].split("|");
                            document.getElementById('mandal').options[i+1] = new Option(valueLabelPair[0], valueLabelPair[1]);
                        }
                    }
					else {
                        alert("Error during AJAX call. Please try again");
                    }
                }
            }
        </script>


</head>
<%
   ms.Connect();
   PreparedStatement stmt1 = ms.Connect().prepareStatement("Select distinct(qualname) from qualification ;");
   PreparedStatement stmt2 = ms.Connect().prepareStatement("select distinct(profname) from proffession ;");
   PreparedStatement stmt3 = ms.Connect().prepareStatement("select distinct(state) from states ;");
   ResultSet rs1 = stmt1.executeQuery();
   ResultSet rs2 = stmt2.executeQuery();
   ResultSet rs3 = stmt3.executeQuery();
%>

    <body>
        <form action="RegServlet" method="post" enctype="multipart/form-data" name="register" class="greenlink_no_left_padding" id="register" >
          <table width="100%" border="0" align="center" cellpadding="0" cellspacing="0" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">
                    <tr>
                      <th height="13" colspan="8" bgcolor="#D8F2C9" class="style44"><h3 align="center" class="orangetext style1">SHANTI CHAKRA FOUNDATION - REGISTRATION FORM </h3>                       </th>
                    </tr>
                    <tr>
                      <th height="14" colspan="8" bgcolor="#FFFF99" class="style44"><div align="center"><span class="style45">REGD OFF: Plot No.9,  ADITYA NAGAR, NEREDMET, SECUNCERABAD - 500056 </span></div></th>
                    </tr>
                    <tr>
                        <td colspan="8"  class="redtext">MEMBER DETAILS : </td>
                    </tr>
                    <tr>
                      
                      <td colspan="6" class="style38"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">
                        <tr>
                          <td width="50%" height="328"><table width="100%" border="0" cellpadding="0" cellspacing="0" class="greentext" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">
                            <tr>
                              <td height="24" colspan="2" align="center" bgcolor="#FFFFD5" class="bluetext"><pre>Personal Details </pre></td>
                            </tr>
                            <tr>
                              <td width="41%" class="greentext"><span class="style44">NAME* :</span></td>
                              <td width="59%"><span class="style44">
                                <input type="text" name="name" id ="name"   onkeydown="javascript:Getdecl()"/>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">SURNAME* :</span></td>
                              <td><span class="style44">
                                <input name="surname" type="text" id = "surname" />
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">GENDER* :</span></td>
                              <td><span class="style44">
                                <select name="sex" id="sex" onchange="javascript:SpouseSex();">
                                  <option selected="selected">Select</option>
                                  <option>Male</option>
                                  <option>Female</option>
                                </select>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">DOB ( DD-MM-YYYY) * :</span></td>
                              <td><span class="style44">
                                <input name="dob" type="text" class="tabledata" id="dob" size="15" onchange="javascript:sendage();"/>
                                <input name="b1" type="button" id="b1" value="cal" />
                                <script type="text/javascript">
                                Zapatec.Calendar.setup({
                                    step              : 1,
                                    electric          : false,
                                    inputField        : "dob",
                                    button            : "b1",
                                    ifFormat          : "%d-%m-%Y",
                                    daFormat          : "%d-%m-%Y"
                                });
                              </script>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">AGE</span></td>
                              <td><span class="style44">
                                <input name="age" type="text" id = "age" size="3" />
                                Yrs</span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">CASTE : </span></td>
                              <td><span class="style44">
                                <input name="caste" type="text" id="caste"/>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">MEMEBER PHOTO : </span></td>
                              <td><span class="style44">
                                <input name = "photo" type="file" id="photo" />
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">QUALIFICATION :</span></td>
                              <td><span class="style44">
                                <select name="qual" id ="qual">
                                  <option>Select</option>
                                  <%
                                     while (rs1.next() == true) {%>
                                  <option> <%=rs1.getString(1)%></option>
                                  <%System.out.print("qualification table qualname " + rs1.getString(1));
        							}
                                       %>
                                </select>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">RESIDENCE ADDRESS* :</span></td>
                              <td><span class="style44">
                                <textarea name="resadd" id ="resadd"></textarea>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">STATE* :</span></td>
                              <td><span class="style44">
                                <select name="state" id="state" onchange="javascript:getDistricts();">
                                  <option> </option>
                                  <%
                                while (rs3.next() == true) {%>
                                  <option><%=rs3.getString(1)%></option>
                                  <%}%>
                                </select>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">DISTRICT* :</span></td>
                              <td><span class="style44">
                                <select name="district" id="district" onchange="javascript:getMandals();">
                                </select>
                              </span></td>
                            </tr>
                            <tr>
                              <td class="greentext"><span class="style44">Mandal* :</span></td>
                              <td><span class="style44">
                                <select name="mandal" id="mandal">
                                </select>
                              </span></td>
                            </tr>
                          </table></td>
                          <td width="50%" valign="top"><table width="100%" border="0" cellpadding="0" cellspacing="0" class="greenlink_no_left_padding" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">
                            <tr>
                              <td height="21" colspan="2" align="center" bgcolor="#FFFFD5" class="bluetext"><pre>Office Details </pre></td>
                            </tr>
                            <tr>
                              <td width="55%" align="left" bgcolor="" class="greentext">PROFESSION/DESIGNATION* : </td>
                              <td width="45%" align="left" bgcolor="" class="style44"><select name="prof" id="prof">
                                  <option value="--">Select Proffession</option>
                                  <%while (rs2.next() == true) 
								{
                                %>
                                  <option><%=rs2.getString(1)%></option>
                                  <% System.out.print("Proffession table profname " + rs2.getString(1));
        						}
                                %>
                                  <option value="-" onclick="textbox_prof">other</option>
                              </select></td>
                            </tr>
                            <tr>
                              <td align="left" bgcolor="" class="greentext">ORGANISATION NAME : </td>
                              <td align="left" bgcolor="" class="style44"><input name="org" type="text" /></td>
                            </tr>
                            <tr>
                              <td align="left" class="greentext">OFFICE ADDRESS : </td>
                              <td align="left" bgcolor="" class="style44"><textarea name="offadd" id ="offadd"></textarea></td>
                            </tr>
                            <tr>
                              <td height="15" align="left" bgcolor="" class="greentext">&nbsp;</td>
                              <td align="left" bgcolor="" class="style44">&nbsp;</td>
                            </tr>
                            <tr>
                              <td height="15" align="left" bgcolor="" class="greentext">&nbsp;</td>
                              <td align="left" bgcolor="" class="style44">&nbsp;</td>
                            </tr>
                            <tr>
                              <td height="15" align="left" bgcolor="" class="greentext">&nbsp;</td>
                              <td align="left" bgcolor="" class="style44">&nbsp;</td>
                            </tr>
                            <tr>
                              <td height="15" align="left" bgcolor="" class="greentext">&nbsp;</td>
                              <td align="left" bgcolor="" class="style44">&nbsp;</td>
                            </tr>
                            <tr>
                              <td height="15" align="left" bgcolor="" class="style44">&nbsp;</td>
                              <td align="left" bgcolor="" class="style44">&nbsp;</td>
                            </tr>
                          </table>
                            <table width="100%" border="0" cellspacing="0" cellpadding="0" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">
                              <tr>
                                <td height="21" colspan="2" align="center" bgcolor="#FFFFD5" class="bluetext"><pre>Contact Details </pre></td>
                              </tr>
                              <tr>
                                <td width="47%" align="left" bgcolor="" class="greentext">RESIDENCE : </td>
                                <td width="53%" align="left" bgcolor="" class="style44"><input type="text" name="rphone" id ="rphone" /></td>
                              </tr>
                              <tr>
                                <td align="left" bgcolor="" class="greentext">OFFICE : </td>
                                <td align="left" bgcolor="" class="style44"><input type="text" name="ophone" /></td>
                              </tr>
                              <tr>
                                <td align="left" bgcolor="" class="greentext">MOBILE*:</td>
                                <td align="left" bgcolor="" class="style44"><input type="text" name="mobile" id="mobile" /></td>
                              </tr>
                              <tr>
                                <td align="left" bgcolor="" class="greentext">EMAIL :</td>
                                <td align="left" bgcolor="" class="style44"><input type="text" name="email" id ="email" />								</td>
                              </tr>
                              <tr>
                                <td align="left" bgcolor="" class="greentext">WEB ADDRESS:</td>
                                <td align="left" bgcolor="" class="style44"><input name="webadd" type="text" /></td>
                              </tr>
                          </table></td>
                        </tr>
                        
                      </table></td>
                    </tr>
                    <tr>
                      <td colspan="8" bgcolor="#FFFFD5" class="style38"><div align="left" class="bluetext">SPOUSE  DETAILS: </div></td>
                    </tr>
                    <tr>
                    
                      <td colspan="6" bgcolor="" class="style44"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">

                        <tr>
                          <td width="21%" class="greentext">NAME : </td>
                          <td width="29%"><input name="spouse_name" type="text" id="spouse_name"/></td>
                          <td width="24%" bgcolor="" class="greentext">GENDER :</td>
                          <td width="26%" bgcolor="" class="style44"><span class="style44">
                            <select name="ssex">
                              <option ></option >
                              <option>Male</option>
                              <option>Female</option>
                            </select>
                          </span></td>
                        </tr>
                        <tr>
                          <td class="greentext">DATE OF BIRTH :</td>
                          <td><input type="text" name="sdob" id="sdob" size ="15"/>
                            <input name="b2" type="button" id="b2" value="..." />
                            <script type="text/javascript">
                                Zapatec.Calendar.setup({
                                    step              : 1,
                                    electric          : false,
                                    inputField        : "sdob",
                                    button            : "b2",
                                    ifFormat          : "%d-%m-%Y",
                                    daFormat          : "%d-%m-%Y"
                                });
                              </script></td>
                          <td bgcolor="" class="greentext"><p>MARRIAGEANNIVERSARY :</p></td>
                          <td bgcolor="" class="style44"><input type="text" name="marday" id ="marday" size="15" />
                              <input name="bm" type="button" id="bm" value="..." />
                              <script type="text/javascript">
                                Zapatec.Calendar.setup({
                                    step              : 1,
                                    electric          : false,
                                    inputField        : "marday",
                                    button            : "bm",
                                    ifFormat          : "%d-%m-%Y",
                                    daFormat          : "%d-%m-%Y"
                                });
                            </script>                          </td>
                        </tr>
                        <tr>
                          <td class="greentext">QUALIFICATION :</td>
                          <td><select name="squal" id="squal">
                            <option> </option>
                            <%
        ResultSet rs4 = stmt1.executeQuery();
        System.out.print("Spouse qualification table qualname " + rs4);
        while (rs4.next() == true) {%>
                            <option> <%=rs4.getString(1)%></option>
                            <%
                                System.out.print("Spouse qualification table qualname " + rs4.getString(1));
        }%>
                          </select></td>
                          <td bgcolor="" class="greentext">PROFESSION : </td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="sprof" id="sprof">
                              <option> </option>
                              <%
        ResultSet rs5 = stmt2.executeQuery();
        while (rs5.next() == true) {
                                %>
                              <option><%=rs5.getString(1)%></option>
                              <%}%>
                            </select>
                          </span> </td>
                        </tr>
                        <tr>
                          <td height="22" class="greentext">ORG/ COMPANY :</td>
                          <td><input name="sorg" type="text" id="sorg" size="25" /></td>
                          <td>&nbsp;</td>
                          <td>&nbsp;</td>
                        </tr>
                      </table></td>
                    </tr>
                    <tr>
                      <td colspan="8" bgcolor="#FFFFD5" class="style38"><div align="left" class="bluetext">CHILDREN  DETAILS: </div></td>
                    </tr>
                    <tr>
                     
                      <td colspan="7" bgcolor="" class="style44"><table width="100%" border="0" cellspacing="0" cellpadding="0" style="border-right: #F8C9CA 1px solid; border-top: #F8C9CA 1px solid; border-left: #F8C9CA 1px solid;  border-bottom: #F8C9CA 1px solid; font-size: 9pt; color: #000000; font-family: Arial;">
                        <tr>
                          <th width="21%" bgcolor="" class="greentext"><span class="style44">NAME OF THE CHILD</span></th>
                          <th width="29%" bgcolor="" class="greentext"><span class="style44">DATE OF BIRTH</span></th>
                          <th width="24%" bgcolor="" class="greentext"><span class="style44">GENDER</span></th>
                          <th width="26%" bgcolor="" class="greentext"><span class="style44">QUALIFICATION </span></th>
                        </tr>
                        <tr>
                          <td bgcolor="" class="style44">1)
                            <input name="c1name" type="text" id="c1name" /></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <input type="text" name="c1dob" id="c1dob"  size ="15" />
                            <input name="b3" type="button" id="b3" value="..." />
                            <script type="text/javascript">
                                    Zapatec.Calendar.setup({
                                        step              : 1,
                                        electric          : false,
                                        inputField        : "c1dob",
                                        button            : "b3",
                                        ifFormat          : "%d-%m-%Y",
                                        daFormat          : "%d-%m-%Y"
                                    });
                                </script>
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="c1sex" id ="c1sex">
                              <option ></option >
                              <option>Male</option>
                              <option>Female</option>
                            </select>
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="c1qual" id="c1qual">
                              <option> </option>
                              <% ResultSet rs6 = stmt1.executeQuery();
        while (rs6.next() == true) {%>
                              <option> <%=rs6.getString(1)%></option>
                              <%}%>
                            </select>
                          </span></td>
                        </tr>
                        <tr>
                          <td bgcolor="" class="style44"><span class="style44">2)
                              <input type="text" name="c2name" id="c2name" />
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <input type="text" name="c2dob" id="c2dob"  size ="15" />
                            <input name="b4" type="button" id="b4" value="..." />
                            <script type="text/javascript">
                                    Zapatec.Calendar.setup({
                                        step              : 1,
                                        electric          : false,
                                        inputField        : "c2dob",
                                        button            : "b4",
                                        ifFormat          : "%d-%m-%Y",
                                        daFormat          : "%d-%m-%Y"
                                    });
                                </script>
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="c2sex" id ="c2sex">
                              <option ></option >
                              <option>Male</option>
                              <option>Female</option>
                            </select>
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="c2qual" id="c2qual">
                              <option> </option>
                              <%
        						ResultSet rs7 = stmt1.executeQuery();
        						while (rs7.next() == true) {%>
                              <option> <%=rs7.getString(1)%></option>
                              <%}%>
                            </select>
                          </span></td>
                        </tr>
                        <tr>
                          <td bgcolor="" class="style44">3)
                            <input type="text" name="c3name" id="c3name" />                          </td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <input type="text" name="c3dob" id="c3dob"  size ="15" />
                            <input name="b5" type="button" id="b5" value="..." />
                            <script type="text/javascript">
                                    Zapatec.Calendar.setup({
                                        step              : 1,
                                        electric          : false,
                                        inputField        : "c3dob",
                                        button            : "b5",
                                        ifFormat          : "%d-%m-%Y",
                                        daFormat          : "%d-%m-%Y"
                                    });
                                </script>
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="c3sex" id ="c3sex">
                              <option ></option >
                              <option>Male</option>
                              <option>Female</option>
                            </select>
                          </span></td>
                          <td bgcolor="" class="style44"><span class="style44">
                            <select name="c3qual" id="c3qual">
                              <option> </option>
                              <%
        ResultSet rs8 = stmt1.executeQuery();
        while (rs8.next() == true) {%>
                              <option> <%=rs8.getString(1)%></option>
                              <%}%>
                            </select>
                          </span></td>
                        </tr>

                      </table></td>
                    </tr>
                    <tr>
                       
                      <td height="22" colspan="4" bgcolor="" class="style44"><div align="left" class="bluetext">Reffered By (member ID) </div></td>
                        <td height="22" colspan="2" bgcolor="" class="style44">                          <div align="left" class="style44">
                          <input type="text" name="reffmemid" id="reffmemid" />                        
                      </div></td>
                    </tr>
                    <tr>
                   <td height="52" colspan="8" bgcolor="#FFFFD5" class="style44"><div align="left">
    <input type="checkbox" name="checkbox" id="checkbox" value="checkbox" checked="checked" />
					 <span class="style39">I  <input type = "text" name = "decl" id = "decl"  disabled="disabled"/>
					 <span class="style47">a member of the Scheduled Caste Community, aged 
					 <input type = "text" name = "declage" id = "declage"  disabled="disabled" size="10"/>
					 years, do here by take an oath and solemnly swear to be a member of &quot;SHANTI CHAKRA FOUNDATION&quot; and work towards the achievements of the organisation for the betterment and upliftment of my Community. </span></span> <span class="style48">I will be ever ready to support my people where ever whenever possible and support the theory of &quot;Helping each other and grow together&quot;. </span></div></td>
                    </tr>
                    
                    <tr bgcolor="">
                       
                        <td width="263" align="center"><div align="center"></div></td>
                        <td width="240" align="center"><input name="Submit" type="submit" class="bluetext" id="Submit" onclick="return validate(this.form)" value="SUBMIT" /></td>
                        <td width="57" align="center"><input name="reset" type="reset" class="bluetext" id="reset" value="RESET" /></td>
                        <td colspan="2" align="center">&nbsp;</td>
                        <td width="145" align="center">&nbsp;</td>
                    </tr>
          </table>
      
    </form>
		
    </body>
</html>
